Diet and Exercise are not Always Enough to lose Weight: Weight loss surgery may be an option
Many have tried countless diets, calorie counting, low-carb, juice cleanses, and ultimately the weight one loses comes back all too often. For most people, a healthy balanced diet and regular daily activity are just enough to maintain oneself at a current weight. The prevalence of obesity is greater than 30% in the Valley. For these individuals, maintaining their current weight or gaining weight may lead to a cascade of health problems.
Weight loss surgery, also called bariatric surgery has been demonstrated to be the most effective method for weight loss. There are three weight procedures commonly performed, which are gastric bypass, sleeve gastrectomy and adjustable gastric lap band. The procedures are usually performed laparoscopically, meaning small incisions and faster recovery. The adjustable gastric lap band has fallen out of favor the last few years in part because of decreased weight loss compared to other options.
Gastric bypass surgery consists of forming a smaller stomach “pouch” and rerouting the small intestine. This is the longest standing surgery for weight loss and therefore long-term results have been better studied. It is an excellent option especially for patients with diabetes as many patients may benefit from partial or complete remission of their diabetes.
The sleeve gastrectomy is now becoming as common as gastric bypass. This surgery involves stapling and removing a significant portion of the stomach, resulting in a “sleeve” or banana-shaped tube rather than a pouch. This decreases the volume of one’s stomach and therefore leads to decreased food intake and weight loss. Long-term data has demonstrated that at five years there is an average of 59% excess weight loss among patients.
The average excess weight loss after two years ranges from 50-70%, similar to the 50-80% weight loss achieved after gastric bypass. For example, a patient that is 5 feet and 4 inches tall and weighs 250 pounds may lose over 60 pounds after just two years and maintain this afterwards!
More important than the impact on the waistline and pounds on the scale, are the significant health benefits that result after weight loss surgery. Studies have demonstrated dramatic improvements in conditions such as hypertensive, obstructive sleep apnea, hypercholesterolemia, and diabetes. The benefits are clear and many insurances cover weight loss surgery for obese patients with a Body Mass Index (BMI) of 40 or a BMI of 35 with other associated medical conditions. Weight loss surgery should be seen as a tool. This is a tool that helps patients lose a significant amount of weight, and as a tool to help make permanent lifestyle changes. Any surgery has risks and these along with the benefits of surgery should be thoroughly discussed with your physician.
Weight loss surgery is a successful method to reach and maintain a healthier weight, in the absence of the rebound hunger and weight gain that often accompanies the many fad diets that are out there. For many with obesity, weight loss surgery may be the best chance for better health and improved quality of life.
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Veronica T Guerrero, MD